Intestinal Anastomotic Surgery Aid

ABSTRACT

An intestinal anastomotic surgery aid  1  is constituted with a cylindrical portion  40  for covering the proximal end side of an engaging rod  28 , and a cover portion  41  that extends from the cylindrical portion  40  towards the distal end side of the engaging rod  28 . The proximal end part of the cylindrical portion  40  is inserted to a recessed portion  26  of a device main body  21  to be held to the device main body  21 . The anus-side piece of the intestine is tied with a suture to be held to the outer face of the cylindrical portion  40.

TECHNICAL FIELD

The present invention relates to an intestinal anastomotic surgery aidthat is used in an intestinal anastomotic surgery for anastomosing anintestine that is cut into two by, for example, a surgical operationwith the use of an anastomotic device.

BACKGROUND ART

Conventionally, surgical operations have been performed for removing,for example, a diseased part when a cancer is contracted on the largeintestine of a human being. The intestine is cut into two in suchsurgical operation, so that an intestinal anastomotic surgery isnecessary to anastomose the anus-side piece of the intestine connectedto the anus and the stomach-side piece of the intestine connected to thestomach. When performing the intestinal anastomotic surgery, ananastomotic device that is disclosed in Patent Document 1, for example,is used.

The anastomotic device disclosed in Patent Document 1 uses a largenumber of metallic staplers to anastomose the anus-side piece and thestomach-side piece of the intestine, and the device comprises acylindrical device main body and an umbrella-shaped head that isdetachably attached to the device main body. The device main body isinserted to the anus-side piece of the intestine from the anus. A largenumber of slits from which the staplers are struck out are formed in theouter circumference of the end face in the inserting direction of thedevice main body, and a ring-shaped cutter is provided on the inner sideof each slit. Further, a recessed portion for housing intestine cutoutpieces is formed on the inner side than the cutter in the end face ofthe device main body. Furthermore, at the center part of the end face ofthe above-described device main body, an engaging rod that projectstowards the inserting direction of the device main body is provided in astate to be capable of being retracted into the device main body.Moreover, the above-described head comprises a projected portion to beengaged with the engaging rod of the device main body.

When performing the intestinal anastomotic surgery by using theanastomotic device described above, the device main body is insertedfirst from the engaging rod into the anus-side piece of the intestine.When the device main body is inserted to a prescribed position, the openend of the anus-side piece of the intestine is tied to the engaging rodwith a suture as if to cover the device main body while maintained inthe prescribed position. In the meantime, the open end of the intestineis closed by, for example, suturing after inserting the head into thestomach-side piece of the intestine, while driving the projected portionof the head towards the outside by piercing through the side wall of thestomach-side piece of the intestine.

Then, when the engaging rod is retracted inside the device main bodyafter engaging the projected portion of the head with the engaging rodof the device main body, the open end of the anus-side piece of theintestine and the side wall of the stomach-side piece of the intestinecome into close contact with each other. The staplers struck out fromthe device main body at this time are pressed and bent by the head,after piercing through the open end of the anus-side piece of theintestine and the side wall of the stomach-side piece of the intestine.With this, the anus-side piece and the stomach-side piece of theintestine are anastomosed and, at the same time, part of the intestineon the inner side than the anastomosed part is removed by the cutter ofthe device main body and placed in the recessed portion used for housingintestine pieces. Upon this, the anus-side piece and the stomach-sidepiece of the intestine are connected. Thus, use of the anastomoticdevice eliminates the need for the surgeon to perform a suturingtreatment by using a needle and a suture when anastomosing theintestines. Therefore, it is possible to shorten the time of surgery andto perform the anastomotic surgery easily even in a part within thepelvis cavity where it is difficult to reach by hands.

Patent Document 1: Japanese Unexamined Patent Publication 11-4832 (p2,p3, FIG. 5) DISCLOSURE OF THE INVENTION Problems that the Invention isto Solve

In Patent Document 1, however, the anus-side piece of the intestine isdirectly held at the engaging rod of the device main body, so that theanus-side piece of the intestine is to slide on the outer face of theengaging rod from the point where the engaging rod is started to beretracted to the point where the retraction is ended. When the anus-sidepiece of the intestine slides on the outer face of the engaging rod likethis, the anastomosed part of the anus-side piece of the intestine maybe deformed and shifted from the device main body. If that happens, theanastomosed part of the anus-side piece of the intestine and that of thestomach-side piece of the intestine are not closely fitted with eachother, so that the both may not be anastomosed in a desired manner.

Further, when the anus-side piece of the intestine is directly held atthe engaging rod of the device main body as described above, the openend of the anus-side piece of the intestine needs to be pulled untilreaching the outer face of the engaging rod. Therefore, when the lengthof the anus-side piece of the intestine becomes short because thediseased part is cut out from the part of the intestine closer to theanus, for example, it becomes difficult to pull the open end of theanus-side piece of the intestine until reaching the outer face of theengaging rod to be held thereby. As a result, it may become impossibleto perform an anastomotic surgery by using the anastomotic device.

The present invention has been designed in view of the aforementionedissues. An object of the present invention therefore is to anastomosethe anus-side piece and the stomach-side piece of the intestine in adesired manner by restricting the shift in the position of theanastomosed part of the anus-side piece of the intestine, which may becaused when retracting the engaging rod through which the device mainbody and the head are engaged. In addition, it is an object of thepresent invention to provide an intestinal anastomotic surgery aid,which makes it possible to use the anastomotic device even when thelength of the anus-side piece of the intestine is short.

Means of Solving the Problems

In order to achieve the foregoing objects, in the present invention, acylindrical portion that covers the engaging rod on the device main bodyside is held by the device main body, and the anus-side piece of theintestine is held on the outer face of the cylindrical portion.

Specifically, a first aspect of the present invention is drawn to anintestinal anastomotic surgery aid used for an anastomotic surgery foranastomosing two cutout pieces of an intestine including an anus-sidepiece and a stomach-side piece, the anastomotic surgery being performedusing an anastomotic device including a device main body inserted froman anus to the anus-side piece of the cutout intestine and a headinserted to the stomach-side piece of the cutout intestine, either oneof the device main body and the head having an engaging rod projectingtherefrom, the protruding engaging rod then being engaged with the otherone of the device main body and the head and retracted into the devicemain body thereby anastomosing the anus-side piece and the stomach-sidepiece of the intestine, the intestinal anastomotic surgery aid beingattached to the device main body of the anastomotic device.

The intestinal anastomotic surgery aid is structured such that theintestinal anastomotic surgery aid comprises a cylindrical member thatcovers the device main body side of the engaging rod while maintaining adistance from an outer face of the engaging rod, while the device mainbody and the engaging rod are being integrated, wherein the cylindricalmember is held to the device main body, and the anus-side piece of theintestine is held to an outer face of the cylindrical member.

With this structure, the anus-side piece of the intestine is held to theouter face of the cylindrical member that is held to the device mainbody, while the device main body is being inserted to a prescribedposition of the anus-side piece of the intestine via the anus. In thisstate, since the cylindrical member is formed to cover the engaging rodwhile maintaining a distance from the outer face of the engaging rod andis formed in a larger diameter than the engaging rod, it requires topull only a shorter length of the anus-side piece of the intestinecompared to the conventional case where the anus-side piece of theintestine is held directly to the engaging rod. This makes it possibleto have the intestine held at the device main body through thecylindrical member, even if the length of the anus-side piece of theintestine cannot be secured long enough because the diseased part in thevicinity of the anus is cut out, for example.

Further, since the anus-side piece of the intestine is held to thecylindrical member that covers the engaging rod as described above, theanus-side piece of the intestine does not slide on the outer face of theengaging because of the retracting action of the engaging rod. Withthis, the anastomosed part of the anus-side piece of the intestine isnot to be deformed, and it becomes possible to locate the anastomosedpart at a prescribed position of the device main body. As a result, theanastomosed part of the anus-side piece of the intestine and that of thestomach-side piece of the intestine can securely be fitted with eachother closely, when the engaging rod is retracted completely into thedevice main body.

A second aspect of the present invention is the intestinal anastomoticsurgery aid of the first aspect of the present invention, which isstructured in such a manner that: the engaging rod is provided toproject from the device main body towards an inserting direction of thedevice main body; and a cover member for covering a distal end part ofthe engaging rod is detachably provided to the cylindrical member.

With this structure, the distal end part of the engaging rod of thedevice main body is covered by the cover member. Thus, the distal endpart of the engaging rod does not abut against the side wall and thelike of the intestine to stick therein, when inserting the device mainbody to the anus-side piece of the intestine. By detaching the covermember from the cylindrical member after inserting the device main bodyinto the prescribed position of the anus-side piece of the intestine,the distal end part of the engaging rod is exposed. With this, the headcan be engaged with the engaging rod.

A third aspect of the present invention is drawn to an intestinalanastomotic surgery aid used for an anastomotic surgery for anastomosingtwo cutout pieces of an intestine including an anus-side piece and astomach-side piece, the anastomotic surgery being performed using ananastomotic device including a device main body inserted from an anus tothe anus-side piece of the cutout intestine and a head inserted to thestomach-side piece of the cutout intestine, the device main body havingan engaging rod projecting therefrom, the protruding engaging rod thenbeing engaged with the head and retracted into the device main bodythereby anastomosing the anus-side piece and the stomach-side piece ofthe intestine, the intestinal anastomotic surgery aid being attached tothe device main body of the anastomotic device.

The intestinal anastomotic surgery aid is structured such that: theintestinal anastomotic surgery aid comprises a cylindrical portion thatcovers the device main body side of the engaging rod while maintaining adistance from an outer face of the engaging rod, while the device mainbody and the engaging rod are being integrated; and a cover portion forcovering a distal end part of the engaging rod by extending from thecylindrical portion towards the distal end side of the engaging rod,wherein: the cylindrical member is held to the device main body, and theanus-side piece of the intestine is held to an outer face of thecylindrical member; and the cover portion is detachably integrated withthe cylindrical portion.

As in the case of the first embodiment, with this structure, theanus-side piece of the intestine is held to the outer face of thecylindrical portion that is held to the device main body in thisstructure, while the device main body is being inserted to the anus-sidepiece of the intestine. Thus, it is possible to have the intestine heldat the device main body through the cylindrical portion, even if thelength of the anus-side piece of the intestine cannot be secured longenough. Further, the anus-side piece of the intestine does not slide onthe outer face of the engaging rod because of the retracting action ofthe engaging rod. Therefore, the anastomosed part of the anus-side pieceof the intestine and that of the stomach-side piece of the intestine cansecurely be fitted with each other closely, when the engaging rod isretracted completely into the device main body.

Further, the distal end part of the engaging rod of the device main bodyis covered by the cover portion when the intestine anastomotic surgeryaid is attached to the device main body. Thus, the distal end of theengaging rod does not abut against the side wall and the like of theintestine to stick therein, when inserting the device main body to theanus-side piece of the intestine. By detaching the cover portion fromthe cylindrical portion after inserting the device main body into theprescribed position of the anus-side piece of the intestine, the distalend part of the engaging rod is exposed. With this, the head can beengaged with the engaging rod.

A fourth aspect of the present invention is the intestinal anastomoticsurgery aid of the third aspect of the present invention, which isstructured in such a manner that the cover portion is provided with aprotector portion for preventing the distal end part of the engaging rodfrom piercing therethrough.

With this structure, it is possible to prevent the distal end part ofthe engaging rod from piercing through the cover portion, when insertingthe device main body to the anus-side piece of the intestine.

A fifth aspect of the present invention is the intestinal anastomoticsurgery aid of the fourth aspect of the present invention, which isstructured in such a manner that an outer face of the protector portionis covered by a material that is softer than a material used for formingthe protector portion.

For securely preventing the distal end part of the engaging rod frompiercing through the cover portion by forming the protector portion witha hard material, it is possible with this structure to performlow-invasive anastomotic surgery, since the material that is softer thanthe protector portion is abutted against the side wall of the intestinewhen inserting the device main body to the anus-side piece of theintestine.

A sixth aspect of the present invention is the intestinal anastomoticsurgery aid according to any one of the third to fifth aspects of thepresent invention, which is structured in such a manner that: theanus-side piece of the intestine is tied with an elastic member to beheld to the outer face of the cylindrical portion; and the cylindricalportion is provided with an reinforcing portion for suppressing crushingdeformation of the cylindrical portion in a radial direction.

With this structure, crushing deformation of the cylindrical can besuppressed. Therefore, the anus-side piece of the intestine can be tiedsecurely to the cylindrical portion with the elastic member.

A seventh aspect of the present invention is the intestinal anastomoticsurgery aid according to any one the third to sixth aspects of thepresent invention, which is structured in such a manner that: thecylindrical portion is inserted and held to a recessed portion providedon an end face in an inserting direction of the device main body; andthe cylindrical portion is provided with a fragile portion that iscrush-deformed by being pressed by the head and the device main bodywhich come close to each other, when the engaging rod is retracted intothe device main body to anastomose the anus-side piece and thestomach-side piece of the intestine.

With the present invention, the fragile portion of the cylindricalportion is crushed towards the center line direction when anastomosingthe anus-side piece and the stomach-side piece of the intestine, so thatthe size of the cylindrical portion in the center line direction becomesshorter.

An eighth aspect of the present invention is the intestinal anastomoticsurgery aid according to any one of the third to sixth aspects of thepresent invention, which is structured in such a manner that the outerface of the cylindrical portion is provided with an engaging portionwith which the anus-side piece of the intestine tied with the elasticmember is engaged.

With the present invention, the anus-side piece of the intestine tied tothe cylindrical portion with the elastic member is engaged with theengaging portion. Thus, the anus-side piece of the intestine does notcome off from the cylindrical portion. Further, when having theanus-side piece of the intestine held to the cylindrical portion at aposition within the pelvis cavity where it is difficult to be visuallychecked and difficult to be reached by hands, it becomes possible tosecurely hold the intestine at a prescribed position of the cylindricalportion by engaging the intestine with the engaging portion.

EFFECT OF THE INVENTION

With the first aspect of the present invention, the anus-side piece ofthe intestine is held to the outer face of the cylindrical member thatis formed to cover the engaging rod. Thus, it is possible to perform theanastomotic surgery by using the anastomotic device, even in the casewhere the length of the anus-side piece of the intestine cannot besecured long enough because the diseased part in the vicinity of theanus is cut out, for example. Further, since the anus-side piece of theintestine is held to the cylindrical member formed in a shape to coverthe engaging rod, the position of the anus-side piece of the intestineis not shifted when the engaging rod is retracted to the inside thedevice main body. Therefore, the anus-side piece and the stomach-sidepiece of the intestine can be anastomosed in the desired manner.

With the second aspect of the present invention, the distal end part ofthe engaging rod can be covered by the cover member. Thus, the devicemain body can be inserted to the anus-side piece of the intestinesmoothly.

Like the first aspect of the present invention, it is possible with thethird aspect of the present invention to perform the anastomotic surgeryby using the anastomotic device, even in the case where the length ofthe anus-side piece of the intestine is short. At the same time, theanus-side piece and the stomach-side piece of the intestine can beanastomosed in the desired manner. Further, the distal end part of theengaging rod can be covered by the cover member, so that the device mainbody can be inserted to the anus-side piece of the intestine smoothly.

With the fourth aspect of the present invention, it is possible toprevent the distal end part of the engaging rod from piercing throughthe cover portion, when inserting the device main body to the anus-sidepiece of the intestine. This makes it possible in advance to avoid theengaging rod from abutting against the side wall of the intestine,thereby allowing the intestinal anastomotic surgery to be performedsafely.

With the fifth aspect of the present invention, the protector portion iscovered with a material that is softer than the material used forforming the protector portion. Therefore, it is possible to performlow-invasive intestinal anastomotic surgery, while securely preventingthe engaging rod from piercing through the cover portion.

With the sixth aspect of the present invention, it is possible tosuppress crushing deformation of the cylindrical portion with thereinforcing portion. Thus, the anus-side piece of the intestine cansecurely be tied to the cylindrical portion with the elastic member.Therefore, the anus-side piece of the intestine does not come off fromthe cylindrical portion, and the anus-side piece and the stomach-sidepiece of the intestine can be anastomosed securely.

With the seventh aspect of the present invention, the fragile portion ofthe cylindrical portion is crushed and the size thereof in the centerline direction becomes shorter when anastomosing the anus-side piece andthe stomach-side piece of the intestine. Therefore, the cylindricalportion does not intervene in the anastomosis performed between theanus-side piece and the stomach-side piece of the intestine, therebyallowing the both intestines to be anastomosed smoothly.

With the eighth aspect of the present invention, the anus-side piece ofthe intestine tied to the cylindrical portion is engaged with theengaging portion. Thus, it is possible to securely prevent the anus-sidepiece of the intestine from being shifted from a prescribed position ofthe cylindrical portion. Furthermore, the anus-side piece of theintestine can be held to the prescribed position of the cylindricalportion within the pelvis cavity where it is difficult to perform a handwork.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a fragmentary sectional view showing an intestinal anastomoticsurgery aid and an anastomotic device according to a first embodiment ofthe present invention;

FIG. 2A is a front elevational view of a device main body of theanastomotic device when viewed from the distal end side of an engagingrod, and FIG. 2B is a front elevational view of a head when viewed fromthe distal end side of a projected portion;

FIG. 3 is a sectional view of the intestinal anastomotic surgery aid;

FIG. 4 illustrates an enlarged reinforcing portion, in which FIG. 4A isa side view, FIG. 4B is a back view when viewed from the proximal endside, and FIG. 4C is a sectional view;

FIG. 5A is an illustration for describing the state where a diseasedpart is removed from the rectum, and FIG. 5B is an illustration fordescribing the state where the main body of the anastomotic device isinserted to the anus-side piece of the intestine, and the head isinserted to the stomach-side piece of the intestine;

FIG. 6 is a fragmentary sectional view showing an enlarged view of thestate where the anus-side piece of the intestine is tied to acylindrical portion;

FIG. 7 is an illustration for describing the state where a cover portionis detached from the cylindrical portion;

FIG. 8 is an enlarged view showing the vicinity of the anus-side pieceof the intestine;

FIG. 9A is an illustration for describing the state where the head isengaged with the engaging rod, and FIG. 9B is an illustration fordescribing the state where the anus-side piece and the stomach-sidepiece of the intestine are anastomosed;

FIG. 10 is a fragmentary sectional view showing an enlarged view of thevicinity of the anastomosed part of FIG. 9B;

FIG. 11 is an illustration of a modification example of the firstembodiment, which corresponds to FIG. 3;

FIG. 12 is a fragmentary sectional view of the modification example ofthe first embodiment, which shows an enlarged view of the state rightbefore the anus-side piece of the intestine is tied to the cylindricalportion and the cover portion is cut out; and

FIG. 13 illustrates an intestinal anastomotic surgery aid according to asecond embodiment of the present invention, in which FIG. 13A is anillustration corresponding to FIG. 3, and FIG. 13B is an illustrationthat corresponds to FIG. 3, which shows the state where the coverportion is detached.

DESCRIPTION OF NUMERALS

-   -   1 intestinal anastomotic surgery aid    -   20 anastomotic device    -   21 device main body    -   22 head    -   26 recessed portion    -   28 engaging rod    -   40 cylindrical portion    -   41 cover portion    -   42 reinforcing portion    -   43 protector portion    -   48 engaging portion    -   70 cylindrical portion    -   71 cover portion    -   A anus-side intestinal    -   B stomach-side piece    -   C surgical suture (elastic member)    -   E anus

BEST MODE FOR CARRYING OUR THE INVENTION

In the followings, embodiments of the present invention will bedescribed in details by referring to the accompanying drawings.

First Embodiment

FIG. 1 shows an intestinal anastomotic surgery aid 1 according to afirst embodiment of the present invention. For explaining thisembodiment, an anastomotic device 20 will be described first beforedescribing the intestinal anastomotic surgery aid 1.

The anastomotic device 20 comprises a device main body 21 that isinserted to an anus-side intestinal A among the cut intestines (shown inFIG. 5A), and a head 22 that is inserted to a stomach-side piece B ofthe intestine. The device main body 21 is formed in substantially acylindrical shape. As shown in FIG. 2A, a large number of slits 24 fromwhich metallic staplers 23 (shown in FIG. 10) are struck out are formedin the outer circumference of the end face in the inserting direction ofthe device main body 21, and a ring-shaped cutter 25 is provided on theinner side than the slits 24 in the end face of the device main body 21.The blade edge of the cutter 25 is positioned on substantially the sameplane as the end face of the device main body 21.

Further, a recessed portion 26 for housing the intestine pieces isformed on the inner side than the cutter 25 in the end face of thedevice main body 21. The bottom face of the recessed portion 26 extendssubstantially orthogonally to the center line of the device main body21, and a hole portion 27 is provided at the center of the bottom face,to which an engaging rod 28 is inserted. This engaging rod 28 is formedwith a metallic material such as stainless steel, for example, and it isformed to extend straight towards the center line direction of thedevice main body 21. As shown in FIG. 1, the middle part of the engagingrod 28 in the longitudinal direction is formed thinner than the proximalend part and the distal end part thereof. Further, the proximal end partis formed to have a smaller diameter than the distal end part.Furthermore, the distal end part of the engaging rod 28 is formedacutely.

Further, an actuator (not shown) for driving the above-describedengaging rod 28 back and forth in the center line direction is providedinside the device main body 21. This actuator is that of a knownstructure, which operates by a supply of electricity. A connecter 29 isprovided on the opposite side with respect to the inserting direction ofthe device main body 21, to which an end of a code 30 for supplying theelectricity to the above-described actuator is connected. Furthermore,the anastomotic device 20 comprises a controller (not shown) forsupplying the electricity to the actuator, and the other end of theabove-described code 30 is connected to the controller. When theelectricity is supplied from the controller and the actuator retractsthe engaging rod 28, the engaging rod 28 is drawn into the device mainbody 21 to be housed therein. In the meantime, as shown in FIG. 1, whenthe actuator drives out the engaging rod 28, the engaging rod 28 isprojected from the recessed portion 26.

Further, a large number of staplers 23 are enclosed inside the devicemain body 21 by corresponding to the layout of the slits 24. Eachstapler 23 is formed substantially in a U-shape, and arranged in such amanner that the open side thereof faces towards the outer side from theslit 24. Furthermore, a striking mechanism (not shown) for striking outthe staplers by the operation of the above-described actuator isenclosed inside the device main body 21.

Further, the head 22 is formed substantially in an umbrella shape, whichcomprise a circular plate member 35 formed to correspond to the end-faceshape in the inserting direction of the device main body 21, a projectedportion 36 that projects towards the center line direction from thecenter part of the circular plate member 35 to be engaged with theabove-described engaging rod 28, and a swollen member 37 formed to swellout on the opposite side with respect to the projected portion 36 of theabove-described circular plate member 35.

The above-described circular plate member 35 is formed by molding ametallic material such as stainless steel, for example, and a largenumber of pits 38 are formed by corresponding to the above-describedslits 24 in the outer circumference of the surface that faces towardsthe device main body 21, as shown in FIG. 2B. These pits 38 are forpressing and bending the open-side ends of the staplers 23 that arestruck out from the slits 24. Further, the blade edge of the cutter 25of the above-described device main body 21 is to abut against the innerside than the pits 38 of the circular plate member 35.

Further, the above-described projected portion 36 is formed by moldingthe same metallic material as that of the circular plate member 35, andthe above-described engaging rod 28 is inserted to the inner side of theprojected portion 36. The projected portion 36 is provided with anengaging mechanism (not shown) for preventing it from being detachedfrom the engaging rod 28 by being engaged to the middle part in thelongitudinal direction of the inserted engaging rod 28. Furthermore, theabove-described swollen member 37 is formed by molding a resin material,and it is fixed to the above-described circular plate member 35.

Next, the structure of the intestinal anastomotic surgery aid 1 will bedescribed. As shown in FIG. 1 and FIG. 3, the structure of theintestinal anastomotic surgery aid 1 is formed in a cylindrical shape asa whole, and the entire length is set to be within a range of about 40mm to 50 mm by corresponding to the shape of the above-describedanastomotic device 20. The above-described intestinal anastomoticsurgery aid 1 comprises a cylindrical portion 40 for covering theproximal end side of the above-described engaging rod 28, and a coverportion 41 for covering the distal end side of the engaging rode 28 bybeing extended towards the distal end side of the engaging rod 28continuously from the cylindrical portion 40. The cylindrical portion 40has a circular cross section, and the outer diameter is set as about 11mm. The cylindrical portion 40 is formed in such a manner that the innerface is distant from the outer face of the above-described engaging rod28, and the anus-side piece A of the intestine is held at the outer faceof the cylindrical portion 40 by being tied with a surgical suture Cthat is an elastic member, as shown in FIG. 6. Further, the coverportion 41 is formed in a cylindrical shape with a bottom, and the outerdiameter is set as about 9 mm,

Each of the above-described cylindrical portion 40 and the cover portion41 is formed in a double-layered structure. The inner layer of thecylindrical portion 40 is constituted with a reinforcing portion 42 forrestricting crushing deformation of the cylindrical portion 40 in theradial direction. Meanwhile, the inner layer of the cover portion 41 isconstituted with a protector portion 43 for preventing the engaging rod28 from piercing through the cover portion 41. Furthermore, the outerfaces of the above-described reinforcing portion 42 and the protectorportion 43 are covered by an outer layer portion 44 that is fittedclosely with the outer faces thereof to integrate the reinforcingportion 42 and the protector portion 43. Like this, the reinforcingportion 42 and the protector portion 43 are provided separately andintegrated by the outer layer portion 44. Therefore, by cutting theboundary portion between the reinforcing portion 42 and the protectorportion 43 in the outer layer portion 44, the cover portion 41 can beeasily detached from the cylindrical portion 40.

The above-described reinforcing portion 42 is formed byinjection-molding polypropylene, for example. As shown in FIG. 4, inabout a half of the peripheral wall of the reinforcing portion 42 on theproximal end side, a large number of notches 45 extending towards thecenter line direction are formed with a distance provided therebetweenin the circumferential direction. With this, the peripheral wall on theproximal end side is divided into a plurality of sections in thecircumferential direction. By dividing the peripheral wall on theproximal end side, the proximal end of the peripheral wall becomeslikely to bend and deform to be displaced towards the outer or innerside in the radial direction, when the reinforcing portion 42 is pressedtowards the center line direction. As a result, the reinforcing portion42 can be easily crushed and deformed towards the center line direction.

The above-described protector portion 43 is formed by injection-moldingpolypropylene, for example. As shown in FIG. 1 and FIG. 3, it is formedthicker than the above-described reinforcing portion 42. The distal endface of the protector 43 is constituted with a curving face that curvestowards the outer side. The proximal end side of the protector portion43 is formed in a tapered shape where the diameter expands towards theproximal end side. The outer face of this proximal end part continues tothe outer face of the above-described reinforcing portion 42. Further,the proximal end face of the protector portion 43 is formed to beclosely fitted with the distal end face of the above-describedreinforcing portion 42.

The above-described outer layer portion 44 is formed with a resinmaterial that is softer than that of the protector portion 43. Forexample, silicon, polyvinyl chloride, or the like may be used as theresin material. The distal end part of the outer layer portion 44 isformed to curve by corresponding to the shape of the distal end part ofthe above-described protector portion 43, and it is formed thicker thanother parts of the outer layer portion 44. By forming the outer layerportion 44 with a soft material as mentioned above, it becomes easy tobe deformed by the external force. The outer layer portion 44 andproximal end side of the above-described reinforcing portion 43 togetherconstitute a fragile portion of the present invention.

Further, an engaging portion 48 is provided on the outer face of thecylindrical portion 40, with which the piece A of the intestine isengaged when the anus-side piece A of the intestine is tied with thesuture C. The engaging portion 48 is constituted with a first projectedline 49 that projects from the outer layer portion 44 towards the outerside of the radial direction and extends in the circumferentialdirection, and a second projected line 50 that extends in the samemanner from the first projected line 49 towards the proximal end side ata distant position. The height of the projection of the first projectedline 49 is formed higher than that of the second projected line 50.

Further, a proximal end side projected portion 51, which projectstowards the outer side of the radial direction and extends in thecircumferential direction, is provided in the proximal end part of thecylindrical portion 40. The distal end in the projecting direction ofthe proximal end side projected portion 51 abuts against the inner faceof the recessed portion 26 to prevent the cylindrical portion 40 fromcoming off from the recessed portion 26, when the cylindrical portion 40is inserted to the recessed portion 26 of the device main body 21.

Next, the point for using the above-described intestinal anastomoticsurgery aid 1 will be described. This embodiment refers to the case of asurgical operation on a rectal cancer performed when there is a cancercontracted in the vicinity of the anus E of the rectum D, andexplanations will be provided for the case where the anus-side piece Aof the intestine and the piece B that is the sigmoid colon on thestomach side are anastomosed after removing the diseased part. FIG. 5Ashows the state where the diseased part is removed, and each of theanus-side piece A of the intestine and the stomach-side piece B of theintestine is left open. Reference code F indicates the sacrum region andG indicates the abdominal region.

First, as shown in FIG. 1, the cylindrical portion 40 of the intestinalanastomotic surgery aid 1 is inserted to the recessed portion 26 of thedevice main body 21 to attach the aid 1 to the device main body 21.Then, the distal end side of the cover portion 41 of the intestinalanastomotic surgery aid 1 is inserted to the anus-side piece A of theintestine from the anus E until the device main body 21 reaches aprescribed position, as shown in FIG. 5B. In this state, the engagingrod 28 of the device main body 21 is covered by the cover portion 41.Moreover, the distal end face of the cover portion 41 is curved, so thatthe engaging rod 28 does not abut against the side wall of the anus-sidepiece A of the intestine to stick therein. Further, the protectorportion 43 is provided to the cover portion 41. Thus, the engaging rod28 is prevented from piercing through the cover portion 41, so that theengaging rod 28 does not abut against the side wall A of the intestine.Furthermore, the protector portion 43 is covered by the soft outer layerportion 44. Moreover, the distal end part of the outer layer 44 isthicker than the other parts, so that the soft material is the one tocome in contact with the side wall of the piece A of the intestine.

When the device main body 21 is inserted to the prescribed position, thedevice main body 21 and the cylindrical portion 40 are covered by theanus-side piece A of the intestine. Meanwhile, the cover portion 41projects towards the outer side from the open end part of the anus-sidepiece A of the intestine. Then, the suture C that is tied in a loop inadvance is moved from the distal end of the cover portion 41 towards theproximal end side to be hanged on the anus-side piece A of theintestine. Then, as shown in FIG. 6, the suture C is dropped between thefirst projected line 49 and the second projected line 50 to tie theanus-side piece A of the intestine to the cylindrical portion 40tightly. At that time, the cylindrical portion 40 is reinforced by thereinforcing portion 42, so that the cylindrical portion 40 is notcrushed towards the radial direction, and the anus-side piece A of theintestine is securely held to the cylindrical portion 40. Furthermore,even though the vicinity of the anus E of the rectum D is located in adeep area within the pelvis cavity, so that it cannot be visuallychecked and reached by hands, it is possible with the embodiment to holdit to the cylindrical portion 40 easily and securely by groping, sincethe suture C may simply be dropped between the two projected lines 49and 50 for holding the anus-side piece A of the intestine to thecylindrical portion 40.

Further, since the cylindrical portion 40 has a shape to cover theengaging rod 28 and has a larger diameter than the engaging rod 28, itrequires to pull only a shorter length of the anus-side piece A of theintestine compared to the conventional case where the anus-side piece Aof the intestine is held directly to the engaging rod 28. This makes itpossible to have the piece A of the intestine held at the device mainbody 21 through the cylindrical portion 40, even if the length of theanus-side piece A of the intestine cannot be secured long enough becausethe diseased part in the vicinity of the anus E is cut out.

In the meantime, the head 22 is inserted from the swollen member 37 sideof the head 22 to the stomach-side piece B of the intestine, and theprojected portion 36 is extruded to the outer side from the open endpart of the stomach-side piece B of the intestine. The open end part ofthe stomach-side piece B of the intestine is tied and held to theprojected portion 36 with the suture C.

Then, as shown in FIG. 7 and FIG. 8, the cover portion 41 is detachedfrom the cylindrical portion 40 by cutting the boundary area between thereinforcing portion 42 and the protector portion 43 of the outer layerportion 44 by a scalpel, for example, in the circumferential direction.When the cover portion 41 is detached from the cylindrical portion 40,the distal end side of the engaging rod 28 is exposed. Then, as shown inFIG. 9A, the head 22 is brought closer to the device main body 21 toinsert the engaging rod 28 to the inside the projected portion 36 of thehead 22, so that it is engaged with the engaging rod 28.

By supplying the electricity to the device main body 21 by thecontroller thereafter, the engaging rod 28 is retracted to the insidethe device main body 21. With this, the head 22 comes close to thedevice main body 21, and the open end part of the anus-side piece A ofthe intestine and the open end part of the stomach-side piece B of theintestine come in contact with each other.

When retracting the engaging rod 28, the anus-side piece A of theintestine does not slide on the outer face of the engaging rod 28 by theretracting action of the engaging rod 28, since the anus-side piece A ofthe intestine is held on the outer face of the cylindrical portion 40.Therefore, the anastomosed part of the anus-side piece A of theintestine is not to be deformed, and it becomes possible to locate theanastomosed part at a prescribed position of the device main body 21. Asa result, the anastomosed part of the anus-side piece A of the intestineand that of the stomach-side piece B of the intestine can securely befitted closely with each other.

Further, when the head 22 is close to the device main body 21, as shownin FIG. 10, the cylindrical portion 40 is pressed towards the centerline direction by the head 22 and the bottom face of the recessedportion 26 of the device main body 21. Because of the load imposed atthis time, the peripheral wall of the reinforcing portion 42 is bent tobe deformed, while the soft outer layer 44 is crushed to be deformed.With this, the cylindrical portion 40 is housed in the recessed portion26 of the device main body 21 without hindering the head 22 from comingcloser to the device main body 21.

Then, the staplers 23 struck out from the slits 24 of the device mainbody 21 pierce through the open end part of the anus-side piece A of theintestine and that of the stomach-side piece B of the intestine, and arebent by reaching at the pits 38 of the head 22, thereby anastomosing theanus-side piece A of the intestine and the stomach-side piece B of theintestine. At this time, the cutter 25 of the device main body 21 abutsagainst the head 22, and the regions of the anus-side piece A of theintestine and the stomach-side piece B of the intestine located on theinner side than the anastomosed part thereof are cut out and housedinside the recessed portion 26 of the device main body 21, although notshown.

By removing the device main body 21 and the head 22 from the anus Ethereafter, the anastomotic surgery is completed.

Therefore, with the intestinal anastomotic surgery aid 1 according tothis embodiment, it is possible to perform the anastomotic surgery byusing the anastomotic device 20 even when the length of the anus-sidepiece A of the intestine is short because the diseased part in thevicinity of the anus E of the rectum D is cut out, since the anus-sidepiece A of the intestine is tied with the suture C to be held to theouter face of the cylindrical portion 40 that is formed to cover theengaging rod 28. Furthermore, the anus-side piece A of the intestine isheld to the cylindrical portion 40 that is held to the device main body21, so that the position of the anus-side piece A of the intestine isnot shifted when the engaging rod 28 is retracted to the inside thedevice main body 21. Thus, the anus-side piece A of the intestine can befitted closely to the stomach-side piece B of the intestine, and theboth can be anastomosed in the desired manner.

Further, since the distal end side of the engaging rod 28 is covered bythe cover portion 41, the device main body 21 can be smoothly insertedto the anus-side piece A of the intestine.

Further, the protector portion 43 securely prevents the engaging rod 28from piercing through the cover portion 41, so that the anastomoticsurgery can be performed safely. Furthermore, the soft outer layerportion 44 is the one that is abutted against the side wall of the pieceA of the intestine when inserting the device main body 21 to theanus-side piece A of the intestine, so that the anastomotic surgery canbe performed low-invasively.

Furthermore, since the cylindrical portion 40 is reinforced by thereinforcing portion 42, the anus-side piece A of the intestine can betied tightly to the cylindrical portion 40 with the suture C. With this,the anus-side piece A of the intestine is not to come off from thecylindrical portion 40, so that the anus-side piece A of the intestineand the stomach-side piece B of the intestine can be anastomosedsecurely.

Further, the cylindrical portion 40 is crushed to be deformed towardsthe center line direction and is housed in the recessed portion 26, whenthe head 22 is drawn towards the device main body 21. Therefore, thecylindrical portion 40 does not intervene in anastomosing the anus-sidepiece A of the intestine and the stomach-side piece B of the intestine,and the both can be anastomosed smoothly.

Moreover, since the anus-side piece A of the intestine tied to thecylindrical portion 40 is engaged with the engaging portion 48, it ispossible to securely prevent the anus-side piece A of the intestine frombeing shifted from the prescribed position. Further, the anus-side pieceA of the intestine can be securely held at the prescribed position inthe pelvis cavity where it is difficult to perform a hand work.

As in a modification example shown in FIG. 11 and FIG. 12, it is alsopossible to constitute the engaging portion 48 only with a singleprojected line 49, and to constitute the cover portion by asingle-layered structure that is formed by molding silicon, polyvinylchloride, or the like, for example. This cover portion 41 is integratedwith the outer layer portion 44 of the cylindrical portion 40. Further,the distal end part of the cover portion 41 is formed thick, and adistal end side recessed portion 47 to which the distal end part of theabove-described engaging rod 28 is fitted is formed on the inner facethereof. Therefore, when the intestinal anastomotic surgery aid 1 isheld to the device main body 21, the distal end part of the engaging rod28 is fitted in the distal end side recessed portion 47 of theintestinal anastomotic surgery aid 1, and the distal end side of theintestinal anastomotic surgery aid 1 is supported by the engaging rod28. With this, the distal end side of the intestinal anastomotic surgeryaid 1 is stabilized when inserting the anus-side piece A of theintestine to the device main body 21. Furthermore, since the distal endside of the cover portion 41 is thick, the engaging rod 28 does notdamage the inner wall of the piece A of the intestine, when insertingthe intestinal anastomotic surgery aid 1 to the anus-side piece A of theintestine from the anus E.

Further, in this modification example, when the anus-side piece A of theintestine is tied to the cylindrical portion 40 with the suture C, thesuture C is hanged to the side closer to the based end of the of theintestinal anastomotic surgery aid 1 than the projected line 49. Withthis, the anus-side piece A of the intestine can be easily and securelyheld to the cylindrical portion 40 by groping.

Furthermore, in this modification example, a pair of scissors T is usedwhen detaching the cover portion 41 from the cylindrical portion 40, asshown in FIG. 12. The scissors T are so-called right-angle scissors thatare formed in such a manner that a blade T1 comes substantially at rightangle with respect to an operation portion T2, which are used in generalin medical scenes. The blade T1 is inserted from the stomach side to theanus-side piece A of the intestine to be pressed against the projectedline 49, while keeping the blade T1 of the scissors T in an open state.With this, the position of the blade T1 of the scissors T comes at theend part of the cylindrical portion 40 of the cover portion 41.Thereafter, the cover portion 41 can be cut by operating the scissors Tafter housing the engaging rod 28 to the device main body 21 once. Aftercutting the cover portion 41, the engaging rod 28 is driven out. Bycutting the cover portion 41 by using the scissors T in this manner, thecutting process of the cover portion 41 can be performed more safely andquickly compared to the case of using the above-described scalpel.

Second Embodiment

FIG. 13 illustrates the intestinal anastomotic surgery aid 1 accordingto a second embodiment of the present invention. This intestinalanastomotic surgery aid 1 is different from that of the first embodimentonly in respect that a cylindrical member 70 for covering the proximalend side of the engaging rod 28 and a cover member 71 for covering thedistal end side of the engaging rod 28 are detachably united, and otherparts are the same. Thus, the same reference numerals are applied to thecomponents that are the same as those of the first embodiment, anddescriptions thereof are omitted.

The cylindrical member 70 is formed in a double-layered structure of areinforcing portion 72 and an outer layer portion 73 like thecylindrical portion of the first embodiment, while the cover member 71is formed in a single-layered structure. Further, although not shown inthe drawing, a large number of notches extending towards the center linedirection are formed in about a half the peripheral wall of theabove-described reinforcing portion 72 on the proximal end side, and thearea of about a half the cylindrical member 70 on the proximal end sideconstitutes a fragile portion of the present invention. The outer faceof the cylindrical member 70 may be covered by a material that is softerthan the material used for forming the cylindrical member 70.

A ring-shaped extension portion 74 that extends towards the cover member71 than towards the distal end part of the reinforcing portion 72 isprovided on the outer layer portion 73 of the above-describedcylindrical member 70. A protrusion 75 that projects towards the outerside of the radial direction is formed on the outer face of theextension portion 74.

In the meantime, the cover member 71 is formed by injection-moldingpolypropylene, for example, into a cylindrical shape with a bottom. Thecover member 71 is provided with a ring-shaped fitting portion 76 thatis fitted on the outer side of the above-described extension portion 74.The inside diameter of the fitting portion 76 is set to be slightlysmaller than the outer diameter of the above-described extension portion74. A base-side recessed portion 77 with which the protrusion 75 of theabove-described extension portion 74 is engaged is formed on the innerface of the fitting portion 76.

When attaching the above-described cover member 71 to the cylindricalmember 70, the extension portion 74 of the cylindrical member 70 isinserted into the fitting portion 76 of the cover member 71 to engagethe protrusion 75 with the proximal end side recessed portion 77. In themeantime, when detaching the cover member 71 from the cylindrical member70, the cover member 71 is pulled out in such a manner that theextension portion 74 comes off from the fitting portion 76. Thus, theprotrusion 75 is released from the proximal end side recessed portion 77for allowing the cover member 71 to be detached from the cylindricalmember 70. Since the protrusion 75 is formed in the extension portion 74of the soft outer layer portion 73, the extension portion 74 elasticallychanges its shape for enabling the cover member 71 to be attached anddetached with respect to the cylindrical member 71 smoothly.

Further, the distal end part of the cover member 71 is formed thick, anda distal end side recessed portion 78 to which the distal end part ofthe above-described engaging rod 28 is fitted is formed on the innerface thereof. Therefore, when the intestinal anastomotic surgery aid 1is held to the device main body 21, the distal end part of the engagingrod 28 is fitted in the distal end side recessed portion 78 of theintestinal anastomotic surgery aid 1, and the distal end side of theintestinal anastomotic surgery aid 1 is supported by the engaging rod28. With this, the distal end side of the intestinal anastomotic surgeryaid 1 is stabilized when inserting the anus-side piece A of theintestine to the device main body 21. Furthermore, since the distal endside of the cover member 71 is thick, the above-described engaging rod28 does not damage the inner wall of the piece A of the intestine.

The point for using the above-described intestinal anastomotic surgeryaid 1 is as follows. First, the cover member 71 is attached to thecylindrical member 70, and the cylindrical member 70 is held to thedevice main body 21. Then, after inserting the device main body 21 to aprescribed position of the anus-side piece A of the intestine, the openend part of the anus-side piece A of the intestine is held to thecylindrical member 70. At the same time, the cover member 71 is detachedfrom the cylindrical member 70 and the projected portion 36 of the head22 is engaged with the engaging rod 28 of the device main body 21,thereby anastomosing the anus-side piece A of the intestine and thestomach-side piece B of the intestine.

Therefore, as in the case of the first embodiment, it is possible withthe intestinal anastomotic surgery aid 1 according to this embodiment toperform the anastomotic surgery by using the anastomotic device 20, evenwhen the length of the anus-side piece A of the intestine is shortbecause the diseased part in the vicinity of the anus E of the rectum Dis cut out. At the same time, the position of the anus-side piece A ofthe intestine is not shifted when the engaging rod 28 of the device mainbody 21 is retracted to the inside the device main body 21, so that theanus-side piece A of the intestine and the stomach-side piece B of theintestine can be anastomosed in the desired manner.

The aforementioned second embodiment has been described by referring tothe case where the intestinal anastomotic surgery aid 1 is attached tothe anastomotic device 20 in which the engaging rod 28 is provided tothe device main body 21. However, the intestinal anastomotic surgery aid1 of the present invention can also be used for an anastomotic device inwhich the engaging rod is provided to the head. Although not shown inthe drawing, this anastomotic device is so formed that the engaging rodof the head is inserted into the device main body to be engaged therein.In this case, an intestinal anastomotic surgery aid having no covermember may be used.

Further, the intestinal anastomotic surgery aid 1 of the presentinvention can be used not only for an intestinal anastomotic surgeryoperated for a rectal cancer but also for the case where the cutoutintestines are anastomosed by using the anastomotic device 20.

Furthermore, the intestinal anastomotic surgery aid 1 of the presentinvention can also be used for the case where the side-to-endanastomosis is performed as in the conventional case, in addition to thecase of the above-described embodiments where the end-to-end anastomosisis performed. That is, after inserting the head 22 to the stomach-sidepiece B of the intestine, the open end part of the piece B of theintestine is closed by suturing. At the same time, the projected portion36 of the head 22 is projected out to the outer side by having itpierced through the side wall of the stomach-side piece B of theintestine, and the projected portion 36 is engaged with the engaging rod28 of the device main body 21 to anastomose the anus-side piece A of theintestine and the stomach-side piece B of the intestine.

Further, the engaging rod 28 is moved by the actuator of the device mainbody 21 in each of the above-described embodiments. However, theengaging rod 28 may be moved manually, for example.

Furthermore, in each of the above-described embodiments, the engagingportion 48 is constituted with the first projected line 49 and thesecond projected line 50 continuing in the circumferential direction ofthe cylindrical portion 40 and the cylindrical member 70. However, theengaging portion 48 may not have to be formed continuously in thecircumferential direction.

INDUSTRIAL APPLICABILITY

As described above, the intestinal anastomotic surgery aid of thepresent invention can be used for the case where an anastomotic surgeryis performed by using an anastomotic device in a surgical operation of arectal cancer, for example.

1. An intestinal anastomotic surgery aid used for an anastomotic surgeryfor anastomosing two cutout pieces of an intestine including ananus-side piece and a stomach-side piece, the anastomotic surgery beingperformed using an anastomotic device including a device main bodyinserted from an anus to the anus-side piece of the cutout intestine anda head inserted to the stomach-side piece of the cutout intestine,either one of the device main body and the head having an engaging rodprojecting therefrom, the protruding engaging rod then being engagedwith the other one of the device main body and the head and retractedinto the device main body thereby anastomosing the anus-side piece andthe stomach-side piece of the intestine, the intestinal anastomoticsurgery aid being attached to the device main body of the anastomoticdevice, the intestinal anastomotic surgery aid comprising a cylindricalportion that covers the device main body side of the engaging rod whilemaintaining a distance from an outer face of the engaging rod, while thedevice main body and the engaging rod are being integrated, wherein thecylindrical member is held to the device main body, and the anus-sidepiece of the intestine is held to an outer face of the cylindricalmember.
 2. The intestinal anastomotic surgery aid according to claim 1,wherein: the engaging rod is provided to project from the device mainbody towards an inserting direction of the device main body; and a covermember for covering a distal end part of the engaging rod is detachablyprovided to the cylindrical member.
 3. An intestinal anastomotic surgeryaid used for an anastomotic surgery for anastomosing two cutout piecesof an intestine including an anus-side piece and a stomach-side piece,the anastomotic surgery being performed using an anastomotic deviceincluding a device main body inserted from an anus to the anus-sidepiece of the cutout intestine and a head inserted to the stomach-sidepiece of the cutout intestine, the device main body having an engagingrod projecting therefrom, the protruding engaging rod then being engagedwith the head and retracted into the device main body therebyanastomosing the anus-side piece and the stomach-side piece of theintestine, the intestinal anastomotic surgery aid being attached to thedevice main body of the anastomotic device, the intestinal anastomoticsurgery aid comprising: a cylindrical portion that covers the devicemain body side of the engaging rod while maintaining a distance from anouter face of the engaging rod, while the device main body and theengaging rod are being integrated; and a cover portion for covering adistal end part of the engaging rod by extending from the cylindricalportion towards the distal end side of the engaging rod, wherein: thecylindrical member is held to the device main body, and the anus-sidepiece of the intestine is held to an outer face of the cylindricalmember; and the cover portion is detachably integrated with thecylindrical portion.
 4. The intestinal anastomotic surgery aid accordingto claim 3, wherein the cover portion is provided with a protectorportion for preventing the distal end part of the engaging rod frompiercing therethrough.
 5. The intestinal anastomotic surgery aidaccording to claim 4, wherein an outer face of the protector portion iscovered by a material that is softer than a material used for formingthe protector portion.
 6. The intestinal anastomotic surgery aidaccording to claim 3, wherein: the anus-side piece of the intestine istied with an elastic member to be held to the outer face of thecylindrical portion; and the cylindrical portion is provided with areinforcing portion for suppressing crushing deformation of thecylindrical portion in a radial direction.
 7. The intestinal anastomoticsurgery aid according to claim 3, wherein: the cylindrical portion isinserted and held to a recessed portion provided on an end face in aninserting direction of the device main body; and the cylindrical portionis provided with a fragile portion that is crush-deformed by beingpressed by the head and the device main body which come close to eachother, when the engaging rod is retracted into the device main body toanastomose the anus-side piece and the stomach-side piece of theintestine.
 8. The intestinal anastomotic surgery aid according to claim3, wherein the outer face of the cylindrical portion is provided with anengaging portion with which the anus-side piece of the intestine tiedwith the elastic member is engaged.
 9. The intestinal anastomoticsurgery aid according to claim 4, wherein: the anus-side piece of theintestine is tied with an elastic member to be held to the outer face ofthe cylindrical portion; and the cylindrical portion is provided with areinforcing portion for suppressing crushing deformation of thecylindrical portion in a radial direction.
 10. The intestinalanastomotic surgery aid according to claim 4, wherein: the cylindricalportion is inserted and held to a recessed portion provided on an endface in an inserting direction of the device main body; and thecylindrical portion is provided with a fragile portion that iscrush-deformed by being pressed by the head and the device main bodywhich come close to each other, when the engaging rod is retracted intothe device main body to anastomose the anus-side piece and thestomach-side piece of the intestine.
 11. The intestinal anastomoticsurgery aid according to claim 4, wherein the outer face of thecylindrical portion is provided with an engaging portion with which theanus-side piece of the intestine tied with the elastic member isengaged.
 12. The intestinal anastomotic surgery aid according to claim5, wherein: the anus-side piece of the intestine is tied with an elasticmember to be held to the outer face of the cylindrical portion; and thecylindrical portion is provided with a reinforcing portion forsuppressing crushing deformation of the cylindrical portion in a radialdirection.
 13. The intestinal anastomotic surgery aid according to claim5, wherein: the cylindrical portion is inserted and held to a recessedportion provided on an end face in an inserting direction of the devicemain body; and the cylindrical portion is provided with a fragileportion that is crush-deformed by being pressed by the head and thedevice main body which come close to each other, when the engaging rodis retracted into the device main body to anastomose the anus-side pieceand the stomach-side piece of the intestine.
 14. The intestinalanastomotic surgery aid according to claim 5, wherein the outer face ofthe cylindrical portion is provided with an engaging portion with whichthe anus-side piece of the intestine tied with the elastic member isengaged.
 15. The intestinal anastomotic surgery aid according to claim6, wherein: the cylindrical portion is inserted and held to a recessedportion provided on an end face in an inserting direction of the devicemain body; and the cylindrical portion is provided with a fragileportion that is crush-deformed by being pressed by the head and thedevice main body which come close to each other, when the engaging rodis retracted into the device main body to anastomose the anus-side pieceand the stomach-side piece of the intestine.
 16. The intestinalanastomotic surgery aid according to claim 6, wherein the outer face ofthe cylindrical portion is provided with an engaging portion with whichthe anus-side piece of the intestine tied with the elastic member isengaged.